Evaluation of the Effectiveness of a Combined Cognitive-Behavioral Approach and Mindfulness on Learned Helplessness and Regulation of Cognitive Emotion and Blood Pressure in Patients with Coronary Heart Disease

Document Type : Research Paper

Authors

1 MSc of Clinical Science, Ferdous Branch, Islamic Azad University, Ferdous, Iran.

2 PhD in Health Psychology, Torbat Jam Branch, Islamic Azad University, Torbat Jam, Iran.

3 MSc in Psychology, Torbat Jam Branch, Islamic Azad University, Torbat Jam, Iran.

4 MSc in Clinical Psychology, Torbat Jam Branch, Islamic Azad University, Torbat Jam, Iran.

Abstract

Chronic medical diseases are one of the most important causes of death in the world. The aim of this study was to evaluate the effectiveness of a combined cognitive-behavioral approach and mindfulness on learned helplessness and cognitive regulation of emotion and blood pressure in patients with coronary heart disease. The present study is a quasi-experimental with pre-test post-test design with a control group. The statistical population of this study included all heart patients referred to a cardiovascular office in Mashhad, of which at least 30 and for each group of 15 patients with coronary heart disease in the first half of 1400 by Available sampling was selected. In this study, Granfski et al. (2001) Cognitive Emotion Regulation Questionnaire (CERQ), Queens and Nelson Learned Helplessness Questionnaire (2009), and blood pressure measurement by 44 BEURER-B digital device were used. After completing the questionnaires, the data were analyzed using SPSS 26 software. In this regard, multivariate analysis of covariance (MANCOVA) was used to analyze the data. The results indicate the effectiveness of a combination of cognitive-behavioral therapy and mindfulness on the three variables (P <0.05). The components of learned helplessness, cognitive regulation of emotion and blood pressure inefficiently can predispose and perpetuate heart disease. Therefore, in addition to medication, a combination of cognitive-behavioral intervention and mindfulness can be used to prevent recurrence of this chronic disease.

Keywords


تمدنی آصف آباد، سحر؛ مسعودی، شاهد؛ کوهستانی، لاله. (1398). پیش‌بینی پذیرش همسر آزاری بر اساس درماندگی و تصویر بدنی در زنان. مجله پزشکی دانشگاه علوم پزشکی مشهد، 62 (ویژه شماره 1)، 53-60.
رنجبران، رضا؛، اکبری، علی؛ دهکردی، مهناز؛ صفاری‌نیا، مجید؛ علیپور، احمد. (1398). اثربخشی آموزش ذهن‌آگاهی بر سرزندگی، بهزیستی روان‌شناختی و فشارخون زنان مبتلا به بیماری‌های قلبی عروقی. سلامت جامعه. 14(2)، 66-77.
قاسم زاده نساجی، سوگند؛ پیوسته گر، مهرانگیز؛ حسینیان، سیمین؛ موتابی، فرشته؛ بنی هاشمی، سارا. (۱۳۸۹). اثربخشی مداخله شناختی رفتاری بر پاسخ های مقابله ای و راهبردهای تنظیم شناختی هیجانات زنان، نشریه بین المللی علوم رفتاری، ۴(۱)، ۳۵. magiran.com/p727915.
کلهرنیا گلکار، مریم؛ بنی‌جمالی، شکوه‌السادات؛ بهرامی، هادی؛ حاتمی، حمیدرضا؛ احدی، حسن. (1393). اثربخشی ترکیب آموزش مدیریت استرس و معنویت درمانی بر فشارخون، اضطراب و کیفیت زندگی بیماران مبتلا به فشارخون بالا. مجله روان شناسی بالینی، پاییز.6(3)، 1-11.
محمدی، فرزانه؛ بقولی، حسین؛ مهریار، امیر هوشنگ؛ سامانی سیامک. (1398). مقایسه اثربخشی درمان شناختی-رفتاری و درمان مبتنی بر پذیرش و تعهد بر علائم پرخاشگری و مانیا در بیماران اختلال دوقطبی. دانش و پژوهش در روان شناسی کاربردی، بهار، 21(3) و 1-13.
 میرنسب، میر محمود؛ قره اقاجی، سعید. (1394). نقش واسطه ای جهت گیری هدف و درماندگی آموخته شده در رابطه بین نظریه های ضمنی هوش و پیشرفت تحصیلی، مجله مطالعات آموزش و پرورش، 1(1)، 1-20. magiran.com/p1929932
Ashori, M., Abkenar, A. S. S. (2021). Emotional intelligence: Quality of life and cognitive emotion regulation of deaf and hard-of-hearing adolescents. Deafness & Education International, 23(2), 84-102.
Bomyea, J., Ball, T. M., Simmons, A. N., Campbell-Sills, L., Paulus, M. P., & Stein, M. B. (2020). Change in neural response during emotion regulation is associated with symptom reduction in cognitive behavioral therapy for anxiety disorders. Journal of affective disorders, 271, 207-214.
Camacho, E. M., Verstappen, S. M., Chipping, J., & Symmons, D. P. (2013). Learned helplessness predicts functional disability, pain and fatigue in patients with recent-onset inflammatory polyarthritis. Rheumatology, 52(7), 1233-1238.
Cheng, M. Y., Zhang, R. X., Wang, M. J., & Chang, M. Y. (2020). Relationship between cognitive emotion regulation strategies and coronary heart disease: an empirical examination of heart rate variability and coronary stenosis. Psychology & Health, 1-17.
Garnefski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual differences, 30(8), 1311-1327.
Gianaros, P. J., Marsland, A. L., Kuan, D. C. H., Schirda, B. L., Jennings, J. R., Sheu, L. K., ... & Manuck, S. B. (2014). An inflammatory pathway links atherosclerotic cardiovascular disease risk to neural activity evoked by the cognitive regulation of emotion. Biological psychiatry75(9), 738-745.
Hawley L. L., Rector N. A, Segal Z. V. (2021). The Relative Impact of Cognitive and Behavioral Skill Comprehension and Use During CBT for Obsessive Compulsive Disorder. Cognitive Therapy and Research, 45, 439-449.
Huang Y, Su Y, Jiang Y, Zhu M. (2020). Sex differences in the associations between blood pressure and anxiety and depression scores in a middle-aged and elderly population: the Irish Longitudinal Study on Ageing (TILDA). Journal of Affective Disorders, 274, 118-125.
Kario, K., Chirinos, J. A., Townsend, R. R., Weber, M. A., Scuteri, A., Avolio, A., ... & Wang, J. G. (2020). Systemic hemodynamic atherothrombotic syndrome (SHATS)–coupling vascular disease and blood pressure variability: proposed concept from Pulse of Asia. Progress in cardiovascular diseases, 63(1), 22-32.
Misciagna, S. (2020). Introductory Chapter: Definition of Cognitive Behavioral Therapy and Its Principal Applications. Cognitive Behavioral Therapy: Theories and Applications, 3.
Momeni, J., Omidi, A., Raygan, F., & Akbari, H. (2018). Comparing the Effects of Mindfulness-Based Stress Reduction and Cognitive Behavioral Therapy on the Quality of Life of Patients with Cardiovascular Disease. International Journal of Body, Mind and Culture, 94-103.
Nyuyki CK, Ngufor G, Mbeh G, Mbanya JC. (2017). Epidemiology of hypertension in Fulani indigenous populations—age, gender and drivers. Journal of Health, Population and Nutrition, 36(1), 35
Quinless, F. W., & Nelson, M. A. (1988). Development of a measure of learned helplessness. Nursing Research, 37(1), 11-15.
Seifollahzadeh, G., Hatami, M., Ahadi, H., Ghaffarinejad, M. (2021). Comparison of the effectiveness of cognitive-behavioral therapy and motivational interviews on social psychological adjustment, cortisol hormone and cognitive emotion regulation in coronary heart disease patients. medical journal of mashhad university of medical sciences, 64(2), -. doi: 10.22038/mjms.2021.18846
Sheldon, S. L. A., Gathright, E. C., Donahue, M. L., Balletto, B., Feulner, M. M., DeCosta, J., ... & Salmoirago-Blotcher, E. (2020). Mindfulness-based interventions for adults with cardiovascular disease: a systematic review and meta-analysis. Annals of Behavioral Medicine, 54(1), 67-73.
Smallheer, B. A., & Dietrich, M. S. (2019). Social support, self-efficacy, and helplessness following myocardial infarctions. Critical care nursing quarterly, 42(3), 246-255.
Smallheer, B. A., Vollman, M., & Dietrich, M. S. (2018). Learned helplessness and depressive symptoms following myocardial infarction. Clinical nursing research, 27(5), 597-616.
Tajeu GS, Booth JN, Colantonio LD, Gottesman RF, Howard G, Lackland DT, Muntner P. (2017). Incident cardiovascular disease among adults with blood pressure< 140/90 mm Hg. Circulation, 136(9), 798-812.
Theofilou, P. (2011). Noncompliance with medical regimen in haemodialysis treatment: A case study. Case Reports in Nephrology2011.
Virani, Alonso, Benjamin, Bittencourt, Callaway, Carson, Heard. (2020). Heart disease and stroke statistics—2020 update: a report from the American Heart Association. Circulation, E139-E596.
Wells, R. E., O’Connell, N., Pierce, C. R., Estave, P., Penzien, D. B., Loder, E., ... & Houle, T. T. (2021). Effectiveness of mindfulness meditation vs headache education for adults with migraine: a randomized clinical trial. JAMA Internal Medicine, 181(3), 317-328.
Wen, M., Liang, Y., Shen, Q., Yu, J., He, P., OuYang, X., & Zauszniewski, J. A. (2021). Effects of Teaching Resourcefulness in Patients with Coronary Heart Disease. Western Journal of Nursing Research, 01939459211020757.
Yusuf, S., Joseph, P., Dans, A., Gao, P., Teo, K., Xavier, D., ... & Pais, P. (2021). Polypill with or without aspirin in persons without cardiovascular disease. New England Journal of Me